Venous thromboembolism remains an important complication of hip-replacement surgery, despite the use of preventive measures. The challenge is to reduce the incidence of this potentially fatal but preventable disease further. Current prophylactic ...

Immediate anticoagulation is considered the treatment of choice for deep-vein thrombosis or pulmonary embolism. This is usually accomplished by the administration of unfractionated heparin for five to seven days,¹–³ at a dose that is monitored to achieve ...

Green tea is widely consumed in Asian countries. It has been hypothesized to have a protective effect against the development of gastric cancer, the second leading cause of death from cancer throughout the world.¹ In a variety of animal models, the ...

Human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma–associated herpesvirus, appears to have a causal role in several diseases, including Kaposi's sarcoma, primary-effusion lymphoma, and multicentric Castleman's disease.¹ Kaposi's sarcoma is the ...

Figure 1. A previously healthy 35-year-old man had increasing dyspnea on exertion over a period of several months. The results of a physical examination and transthoracic echocardiography suggested that he had pulmonary arterial hypertension and severe ...

Deciding which patients should undergo coronary revascularization remains a key challenge in the management of coronary artery disease, with individual physicians' practice patterns varying widely.¹ The recommendation of revascularization is usually made ...

The immunologic specificity of the antigen receptors of T cells and B cells is the result of random shuffling of the many genes that form the DNA code for the antigen-binding site of these receptors.¹–³ Theoretically, this process could generate 10⁹ ...

Aspiration is defined as the inhalation of oropharyngeal or gastric contents into the larynx and lower respiratory tract.¹,² Several pulmonary syndromes may occur after aspiration, depending on the amount and nature of the aspirated material, the ...

The American health care system remains a paradox of abundance and weaknesses.¹ It is the most expensive health care system in the developed world. Its academic medical centers deliver sophisticated care to patients with complex and serious illnesses. The ...

The anticoagulant mechanism of heparin was obscure until 1973,¹ when it was found that heparin enhances by as much as 1000 times the ability of the plasma protein antithrombin to form complexes with thrombin, factor Xa, and factor IXa, thereby inhibiting ...

Gastric cancer was once the leading cause of cancer-related death in most countries, including the United States. Since 1930 the incidence of gastric cancer has steadily decreased throughout the world, with dramatic decreases in the West. In 1994, gastric ...

Every day, physicians must decide whether to recommend medical procedures that may benefit their patients, such as coronary revascularization for a patient with angina, hysterectomy for a patient with dysfunctional uterine bleeding, or carotid ...

What does the unique election of 2000 mean for health policy in the United States? The answer is complex. The closeness of the presidential vote and the divided Congress¹,² suggest that changes will be modest and incremental. Yet Democratic and Republican ...

To the Editor: Esteller and colleagues (Nov. 9 issue)¹ claim that methylation of the O⁶-methylguanine-DNA methyltransferase (MGMT ) promoter is associated with improved responsiveness to carmustine and prolonged survival in patients with high-grade ...

To the Editor: Lindahl and colleagues (Oct. 19 issue)¹ report that elevated levels of troponin T and C-reactive protein are predictors of the long-term risk of death from cardiac causes in patients with unstable coronary artery disease. They specify the ...

To the Editor: In a randomized trial, three quantities related to sample size must be defined so as to ensure small enough error rates to make the conclusions credible: the significance level (α), the power of a test for a particular alternative ...

To the Editor: Transmission of human herpesvirus 8 (HHV-8) remains puzzling, despite the additional insights provided by Pauk et al. (Nov. 9 issue).¹ Whereas sexual transmission may occur, we endorse the authors' reasoning that oral transmission may be a ...

To the Editor: In the second part of their review of the HLA system (Sept. 14 issue),¹ Klein and Sato state that the HLA class II association in human narcolepsy is due to linkage disequilibrium with mutations in the gene coding for the hypocretin type 2 ...

To the Editor: Ciguatera poisoning from fish is caused by a neurotoxin (ciguatoxin) present in the dinoflagellate Gambierdiscus toxicus. The toxin is transferred through herbivorous reef fish to carnivorous tropical reef fish, which are consumed by ...

Depression, one of the most common mental disorders, is particularly widespread among the elderly. Why is this so? Aren't the years after 65 supposed to be the “golden years”? Doesn't the freedom from work and child rearing open up time for all those ...

Immunologic reactivity as a possible cause of disease (immune-mediated tissue injury) was recognized only at the turn of the 20th century. At that time, Ehrlich first introduced the term “horror autotoxicus,” and the tuberculin reaction, anaphylaxis, and ...

During the past two decades, there have been major efforts to understand the influence of the nervous system on immune and inflammatory responses. As a result, it has become clear that the immune system communicates with the neuroendocrine system and that ...

Androgen-Insensitivity Syndrome as a Possible Coactivator Disease Original Article, N Engl J Med 2000:343;856-862.. On page 860, in Figure 2, the labels under the x axis in Panels A and B should be deleted, since 5α-dihydrotestosterone and dexamethasone ...

Hyperparathyroid and Hypoparathyroid Disorders Review Article, N Engl J Med 2000:343;1863-1875.. On page 1871, the sentence that begins 12 lines from the bottom of the left-hand column should have read, “Both syndromes are associated with rearrangements ...